MedicalResearch.com Interview with:Susan Schwab, PhD
Assistant professor at NYU Langone
Skirball Institute of Biomolecular Medicine
Medical Research: What is the background for this study? What are the main findings?Dr. Schwab: T cell acute lymphoblastic leukemia (T-ALL) remains a devastating pediatric disease. Roughly 20% of children do not respond to current therapies. Furthermore, metastasis to the central nervous system is common in T-ALL, and intrathecal chemotherapy, even when successful at eradicating the cancer, causes serious long-term cognitive side-effects.
Here we report that the chemokine receptor CXCR4 is essential for T cell acute lymphoblastic leukemia progression in both mouse and human xenograft models of disease. Consistent with sustained disease remission in the absence of CXCR4, loss of CXCR4 signaling results in decreased levels of c-Myc, which is required for leukemia initiating cell activity. T-ALL cells reside near cells generating the CXCR4 ligand CXCL12 in the bone marrow, and our data suggest that vascular endothelial cells may be an important part of the T-ALL niche.
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MedicalResearch.com Interview with:
Kimberly Allen PhD, RN Assistant Professor
Center for Narcolepsy, Sleep and Health Research
Department Women Children and Family Health Science
Chicago, IL 60612
Medical Research: What is the background for this study? Dr. Allen: Pediatric traumatic brain injuries (TBI) are a leading cause of morbidity and mortality worldwide.Each year in the United States over 1Ž2 million children are admitted to the hospital for traumatic brain injuries (TBIs). Depending on the severity of the injury and how the individual child responds to the primary injury, a range of medical care may be necessary from an overnight hospital admission for observation to admission in the intensive care unit (ICU) and inpatient rehabilitation facility to re-teach and help to recover skills children once knew. The short- and long-term consequences of traumatic brain injuries include: motor and sensory impairments; cognitive, emotional, psychosocial impairments; headaches, and sleep disruptions.
Medical Research: What are the main findings?
Dr. Allen: The main finding from this pilot study with two groups with 15 children in each group: one of children with traumatic brain injuries and one of typically, developing healthy children was that children with traumatic brain injuries have significantly more daytime sleepiness and worse sleep quality compared to the control group. Additionally, children with TBI also had lower overall functional scores (e.g, school, social) compared to the controlled children. All of the surveys were completed by the child’s parent.
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MedicalResearch.com Interview with:
Efrat Amitay, PhD, MPH
School of Public Health
University of Haifa
Mount Carmel, Haifa, Israel
Medical Research: What is the background for this study?
Dr. Amitay: Although childhood cancer is still rare, we are seeing an increase of around 0.9% annually in the incidence rate in the western world. In spite of advancements in treatment technologies, childhood cancer is a leading cause of death among children and adolescents in the western world – accounting for about 12.3% of all deaths among children age 1-14 years in the US. Childhood cancer is also emerging as a major cause of death in other parts of the world where death rates from communicable diseases are declining. Leukemia is the most common type of childhood cancer and accounts for about 30% of all childhood and adolescent cancers.
Medical Research: What are the main findings?
Dr. Amitay: The meta-analysis of all 18 studies indicated that compared with no or shorter duration of breastfeeding, breastfeeding for 6 months or longer was associated with a 19% lower risk for childhood leukemia (OR=0.81, 95% CI, 0.73-0.89). A separate analysis of 15 of those studies indicated that ever being breastfed compared with never being breastfed was associated with an 11% lower risk for childhood leukemia (OR=0.89, 95% CI, 0.84-0.94). All meta-analyses of other sub groups of studies have shown similar associations, indicating that 14%-19% of all childhood leukemia cases may be prevented by breastfeeding for 6 months or more.
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MedicalResearch.com Interview with:
David Katz, MDDivisions of Cardiology, and Neonatology,
University of Colorado School of Medicine
Aurora, Colorado
Medical Research: What is the background for this study? What are the main findings?
Dr. Katz: Sudden infant death syndrome (SIDS) is the leading cause of infant mortality in the US between 1 month and 1 year of life. This is the first large study to demonstrate an association between high altitude and SIDS. In particular there is a doubling of risk above 8,000 feet of elevation relative to below 6,000 feet.
Medical Research: What should clinicians and patients take away from your report?Dr. Katz: There is an association between high altitude residence and Sudden infant death syndrome (SIDS). The reason for this association is still unknown, but hypoxia may be the common link. While the population living above 8000 feet is small in the US, it is large worldwide. Better understanding this association is of great medical importance.
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MedicalResearch.com Interview with:
Ms. Pajau Vangay
Graduate Research Fellow
Biomedical Informatics and Computational Biology
Vice President of Grants, Council of Graduate Students
University of Minnesota
Medical Research: What is the background for this study? What are the main findings?
Response: Previous studies showed links between antibiotic use and unbalanced gut bacteria, and others showed links between unbalanced gut bacteria and adult disease. Over the past year we synthesized hundreds of studies and found evidence of strong correlations between antibiotic use, changes in gut bacteria, and disease in adulthood.
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MedicalResearch.com Interview with:
Jeff Bridge, Ph.D
Center for Innovation in Pediatric Practice
Principal InvestigatorThe Research Institute at Nationwide Children's Hospital
Medical Research: What is the background for this study?
Dr. Bridge: Suicide is a leading cause of death among children younger than 12 years. Suicide rates in this age group have remained steady overall for the past 20 years, but this is the first national study to observe higher suicide rates among black children compared to white children. Little is known about the epidemiology of suicide in this age group, as prior research has typically excluded children younger than 10 years old and investigated trends only within specific older age groups.
Medical Research: What are the main findings?
Dr. Bridge: We found that suicide ranked 14th as a cause of death among 5- to 11-year old black children in 1993-97 but rose to 9th in 2008-12. For white children, suicide ranked 12th in 1993-97 and 11th in 2008-12. Rates have remained stable in Hispanic and non-Hispanic children. The findings in this study highlight an emerging racial disparity in the epidemiology of childhood suicide.
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MedicalResearch.com Interview with:
Matthew Pearce
NHS Gloucestershire Clinical Commissioning Group
UK
Medical Research: What is the background for this study? What are the main findings?
Response: Despite evidence to suggest that the prevalence of childhood obesity in the UK has stabilized in recent years, we know that approximately one in five children start their school life either overweight or obese, increasing to one in three children by the last year in primary school. Our research was the first to undertake an in-depth analysis on the UK’s National Child Measurement Programme (NCMP) and retrospectively track the weights of individual children over a 7-year period. Our study included a sample of 1863 children in South Gloucestershire, Bristol in the UK.
Our results were found to be similar to cross sectional data with obesity prevalence approximately doubling between the first (4/5yrs old) and last year (10/11yrs old) of primary school. Our findings provide little reassurance that those children who are obese in early childhood ‘grow out of ’ excess adiposity. Including overweight, we found that 84% of obese children at Reception year went on to be either overweight or obese by Year 6. Although previous studies have failed to identify any significant differences in BMI change between boys and girls during mid-childhood, our research found that more boys than girls dropped a weight category (from overweight or obese) by the time they reached Year 6. We found that the odds ratios of being overweight (BMI ?85th percentile) or obese (?95th percentile) based on BMI at Reception were similar to published literature. Our data found children who are within the upper range of the healthy weight category (75th–85th percentile) at Reception had an increased risk of being overweight or obese by the time they reach year 6. (more…)
MedicalResearch.com Interview with:
Mr. Matthew A. Rysavy, B.S and Edward Bell, MD
Department of Pediatrics, University of Iowa
Iowa City, IA
Medical Research: What is the background for this study? What are the main findings?Response: We were interested in understanding reasons for differences in outcomes among extremely preterm infants among hospitals. This has been shown in many studies. We found that differences among hospitals in whether treatment was initiated for infants born at very early gestations (22, 23, 24 weeks' gestation) accounted for a lot of the variation in hospital-level outcomes at these gestational ages.
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MedicalResearch.com Interview with:
Tejpratap S.P. Tiwari, MD
Meningitis and Bacterial Vaccine Preventable Diseases Branch
Division of Bacterial Diseases
National Center for Immunization and Respiratory Diseases
Division of Global HIV/AIDS, Center for Global Health
Centers for Disease Control and Prevention,
Atlanta, GeorgiaMedical Research: What is the background for this study? What are the main findings?
Dr. Tiwari: Infants younger than one year old in the United States are at highest risk for severe outcomes from pertussis and death. The first childhood pertussis vaccine dose is recommended at 2 months old, with additional doses in the first year of life at 4 and 6 months. Studies have established that pertussis vaccines can protect against pertussis disease, complications, and hospitalization in infants when 1 to 3 doses are administered by six months old. This study’s findings suggest that the first pertussis vaccine dose and appropriate antibiotic treatment protect infants against death, hospitalization, and pneumonia. Improved on-time infant vaccination (at 2, 4, and 6 months) could potentially prevent up to 1 out of every 4 infant pertussis deaths.
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MedicalResearch.com Interview with:
Thomas P. Dompier, PhD, ATC
President and Injury Epidemiologist
Datalys Center for Sports Injury Research and Prevention, Inc
Indianapolis, IN 46202
Adjunct Faculty Appointments
Ohio University Rocky Mountain University of Health Professions
University of South Carolina
Medical Research: What is the background for this study?
D: Dompler: Per the Institute of Medicine’s recent recommendations to better describe the incidence of concussion in sport across the entire spectrum of youth sports (5-23 years), this study is the first to provide an apples-to-apples comparison using epidemiologic data provided by healthcare providers (athletic trainers) who attended all practices and games and used the same methodology to report concussions and student-athlete exposure information.
Medical Research: What are the main findings?D: Dompler:
a. The main findings are that the risk (how many players out of 100 can expect to suffer at least one concussion during the season) is lowest in the youth, and increases with age.
b. Game concussion rates (how many players out of 1000 exposed during a practice or game, includes multiple concussions to the same player) are highest in college but practice concussion rates are lowest in college during practice. This suggests more can be done during high school and youth practices to reduce concussion frequency (e.g. limiting how much time can be devoted to full contact, reducing player-to-player contact by teaching proper tackling without using full contact drills such as the Oklahoma drill and others).
c. While the rate is higher, there is still a substantial number of concussions that occur during practice (because there are more practices), therefore sports medicine staff should be available at both if possible (this is difficult at the youth level because of cost, however).
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MedicalResearch.com Interview with:
Jennifer A. Emond, M.Sc., PhD
Research Instructor
Department of Epidemiology
Geisel School of Medicine at Dartmouth College
Cancer Control Research Program
Lebanon, NH 03756
Medical Research: What is the background for this study? What are the main findings?
Dr. Emond: Several studies have documented a link between consuming alcohol mixed with energy drinks and an increased risk of negative outcomes while drinking, including binge drinking. It is known that mixing energy drinks with alcohol increases the risk for binge drinking--the high caffeine intake consumed when mixing energy drinks with alcohol may cause individuals to feel what is been called "wide-awake drunk," and they may underestimate their level of intoxication. However, most studies to date have been conducted among undergraduate college students, and we wanted to know if those same associations were also observed among adolescents. In our study of 3,342 adolescents and young adults between the ages of 15-23, we also found a positive link between a history of consuming alcohol mixed with energy drinks and abusive alcohol use. Specifically, 22.3% of participants had ever consumed an energy drink mixed with alcohol (including 9.7% of 15-17 year olds), and such a history of mixed use was associated with a more than 4-fold increased likelihood of engaging in binge drinking. Importantly, that association was just as strong among 15-17 year olds as it was among the older participants. One critical component of our study was that we also looked at a validated outcome for alcohol use disorder (i.e., the participants completed the Alcohol Use Disorders Identification Test [AUDIT]), and participants with a history of consuming alcohol mixed with energy drinks were also 4.2 times more likely to meet that clinically defined criteria for alcohol use disorder as defined for adolescents. Again, those associations were observed for all participants, regardless of age.
Our study has limitations. It was cross-sectional, so we cannot prove that mixed use of alcohol and energy drinks causes abusive alcohol use behaviors. However, our study does support that mixed use of alcohol with energy drinks can identify adolescents at risk for alcohol abuse. (more…)
MedicalResearch.com Interview with:
Stephen F. Kingsmore MB ChB BAO DSc FRCPath
Dee Lyons/Missouri Endowed Chair in Genomic Medicine,
Children’s Mercy - Kansas City
Medical Research: What is the background for this study?
Response: The background to this study is that genetic diseases are the leading cause of death in infants and, especially, in infants in neonatal intensive care units. Making a molecular (etiologic) diagnosis of the specific genetic disease is critical for optimal care and decision making for acutely ill infants who are likely to have such diseases. However there are over 5000 known genetic diseases and their presentations overlap considerably in infants. Until now it has not been possible to make timely diagnoses in these infants.
Medical Research: What are the main findings?Response: Rapid whole genome sequencing is a new way of making a genetic disease diagnosis in acutely ill newborns in neonatal intensive care units. It appears to be effective for diagnosis.
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MedicalResearch.com Interview with:
Mark D. DeBoer, MD, MSc, MCR
Associate Professor of Pediatrics
Division of Pediatric Endocrinology, University of Virginia
Medical Research: What is the background for this study? What are the main findings?
Dr. DeBoer: The American Academy of Pediatrics recommends that children watch no more than 2 hours of TV daily. We wanted to see if children watching shorter amounts of TV were more likely to have higher weight status. We found that children in kindergarten who watched 1-2 hours a day were more than 40% more likely to be overweight and obese and gained more unhealthy weight over the next year.
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MedicalResearch.com Interview with:
Holly Gooding, MD, MS
Harvard T.H. Chan School of Public Health
Instructor in Pediatrics at Harvard Medical School
Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital Division of General Internal Medicine
Brigham and Women’s Hospital Boston, MA
Medical Research: What is the background for this study? What are the main findings?
Dr. Gooding: As an adolescent medicine physician, I primarily care for patients between the ages of 12 and 30, although I first trained in internal medicine. One of the things I noticed when I started working with this age group is that pediatric and adult guidelines differ for many conditions. Cholesterol treatment is one condition that comes up frequently, because the NHLBI and the AAP recommend screening youth ages 17 to 21 for cholesterol problems.
The study team and I set out to discover the proportion of American youth ages 17 to 21 who would meet criteria for pharmacologic treatment of abnormal cholesterol levels if clinicians applied the pediatric versus the adult guidelines. We found that 2.6% of young people ages 17 to 21 would qualify for pharmacologic treatment of abnormal LDL cholesterol levels under the pediatric guidelines, but less than 1% would qualify under the adult guidelines. This translates to almost 500,000 youth qualifying for treatment under the pediatric guidelines, but only about 78,000 under the adult guidelines. Those who met pediatric criteria had lower LDL levels but higher proportions of high blood pressure, smoking, and obesity.
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MedicalResearch.com Interview with:
Professor of Pediatrics Hans Bisgaard, MD, DMSc
Copenhagen Prospective Studies on Asthma in Childhood
Herlev and Gentofte Hospital,
University of Copenhagen, Denmark
Medical Research: What is the background for this study?Dr. Bisgaard: Extended breast-feeding is recommended for
newborn children at risk of allergy-associated diseases, but the
evidence of a protective effect on sensitization and these diseases
remains elusive.
Medical Research: What are the main findings?Dr. Bisgaard: Exclusive breastfeeding does not affect
sensitization in early childhood or associated diseases at 7 years
of age in at-risk children.
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MedicalResearch.com Interview with:
Dr Anne K Detjen, MD
Child Lung Health ConsultantInternational Union Against Tuberculosis and Lung Disease
Medical Research: What is the background for this study? What are the main findings?Dr. Detjen: The bacteriological diagnosis of tuberculosis (TB) in children is challenging due to the difficulty in obtaining specimens such as sputum and the lack of an accurate and accessible diagnostic test. In most cases, diagnosis is made on clinical grounds based on a contact history and a combination of signs and symptoms. We included 15 studies in a systematic review and meta-analysis of Xpert for the diagnosis of pulmonary TB in children.
The accuracy of Xpert for diagnosing TB in children is suboptimal, and the majority of children will still have to be diagnosed clinically. However, in settings where it replaces smear microscopy Xpert will increase the likelihood of bacteriological confirmation of TB as well as MDR TB among children. Xpert does not increase the number of confirmed TB cases among culture-negative children. We also found that smear status highly impacted Xpert results, i.e. a higher yield among smear positive compared to smear negative children. Smear positivity increases with bacillary load and might be a proxy for disease severity. Unfortunately, we were not able to assess the performance among children with different stages of disease severity since this was not classified in any of the studies included.
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MedicalResearch.com Interview with:
Dr Fiona McQuaid
Clinical Research Fellow
University of Oxford, United Kingdom
Medical Research: What is the background for this study?Response: Meningococcal B disease is a common cause of sepsis and meningitis
with significant mortality and morbidity. A multicomponent vaccine
against serogroup B meningococcus has been licensed for use in the
Europe, Australia, Canada and recently the USA (though only in the
10-25 years age group) but questions remain about how long the
bactericidal antibodies induced by infant vaccination persist and the
likely breath of strain coverage. This was a follow on study looking
at a group of children aged 5 years who had been vaccinated as infants
and a different group who were vaccinated for the first time at 5
years of age.
Medical Research: What are the main findings?Response: The percentage of children with protective antibody levels who had
been immunized as infants fell in the 20 months since their last
immunization but this varied by the strain of meingococcus B tested
and by the different infant/toddler vaccination schedules.
The children who were vaccinated for the first time at 5 years of age
showed a good antibody response, but most reported pain and redness
around the site of vaccination and 4-10% had a fever.
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MedicalResearch.com Interview with:
Joyce Maalouf MS MPH
Nutrition Epidemiologist
CDC, Atlanta
Medical Research: What is the background for this study? What are the main findings?
Response: Although significant research shows U.S. children are eating too much sodium, data on the top dietary sources contributing to that intake is limited – particularly among babies and toddlers. This study identifies the primary sources of dietary sodium consumed by children from birth to 24-months-old, as well as differences in intake and food source broken down by demographic characteristics including age, gender and race/ethnicity.
Overall, our research revealed that after the age of six months, more than 70 percent of sodium intake comes from foods other than breast milk and infant formula. Commercial baby foods, soups and pasta mixed dishes are top sodium contributors for U.S. infants 6 to 11.9 months, while soups, cheese, pasta mixed dishes and frankfurters and sausages are key contributors among toddlers aged 12 up to 24 months. Top sodium sources varied by race/ethnicity within age groups, suggesting that for sodium reduction to be effective, it needs to occur across a wide variety of foods.
In addition, we found that non-Hispanic black toddlers ate more sodium than non-Hispanic white and Mexican-American children. Average sodium intake increased almost 9-fold from children under six months to those between one and two-years-old, while average energy intake only doubled. This suggests that, during the first two years of life, U.S. children increasingly consume sodium-rich foods.
To determine these findings, we examined eight years of data encompassing more than 2,900 participants between birth and two-years-old. The information was pulled from the nationwide NHANES What We Eat in America survey between 2003 and 2010.
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MedicalResearch.com Interview with:Donald M Lloyd-Jones, MD/ScM
Senior Associate Dean for Clinical and Translational Research, Chair, Department of Preventive Medicine
Director, Northwestern University Clinical and Translational Sciences Institute (NUCATS) Eileen M. Foell Professor
Professor in Preventive Medicine-Epidemiology and Medicine-Cardiology
Northwestern University Feinberg School of MedicineMedicalResearch: What is the background for this study? What are the main findings?Dr. Lloyd-Jones: Previous studies have examined the associations of cardiovascular health, as defined by the American Heart Association, with outcomes in younger and middle-aged adults. Prior studies have also examined the status (i.e., prevalence) of cardiovascular health in adults across the age spectrum, and in adolescents ages 12-19 years. However, no study to date has examined the status of cardiovascular health in children under 12 years of age, so we sought to define it in detail using nationally-representative data.
Overall, although we have inadequate surveillance systems to monitor cardiovascular health optimally in our youngest children, this study shows that there are concerning signals that they are losing the intrinsic cardiovascular health they are born with, even well before age 12 years. The implications for loss of cardiovascular health before adulthood have been well established, with earlier onset of cardiovascular diseases, cancer and other diseases, earlier mortality, lower quality of life and many other adverse consequences.
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MedicalResearch.com Interview with:
Sabine Roza MD Ph.D. and
Ayesha Sajjad MD, Phd student
Department of Child and Adolescent Psychiatry & Psychology
Department of Psychiatry, Erasmus MC,
Rotterdam, The Netherlands.
Medical Research: What is the background for this study? What are the main findings?
Dr. Roza: WHO guidelines recommend six months of exclusive breastfeeding followed by partial breastfeeding until two years for overall optimum growth and development of children. However, the role of breastfeeding duration on child cognitive development remains a topic of continual debate. Previous research has shown mixed results on the role of breastfeeding duration and exclusivity on child IQ. Several methodological differences in study design inhibit comparisons of these studies and thus limit their generalizability. Furthermore, the association of breastfeeding with child cognitive development is subject to confounding by various factors especially maternal IQ. Therefore, we aimed to study the association between breastfeeding duration and breastfeeding exclusivity with non-verbal IQ in children. We used data the Generation R Study, which is a prospective cohort study from fetal life until young adulthood. Due to the large variability in ethnic backgrounds in our study participants, we focused on non-verbal IQ. In a large sample of 3761 children aged on average 6 years, we found an initial advantage of 0.32 points in non-verbal IQ for every increasing month of breastfeeding, which strongly attenuated after adjustments were made for child factors, maternal factors, sociodemographic factors, parental lifestyle and maternal IQ. Similar attenuation of effect sizes was observed for breastfeeding duration as a categorical variable and duration of exclusive breastfeeding.
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MedicalResearch.com Interview with:
Dr. Jennifer Lind PharmD, MPH
Division of Birth Defects and Developmental Disabilities,
CDC
Medical Research: What is the background for this study? Dr. Lind: CDC and Florida investigators published a new report describing the characteristics of infants with neonatal abstinence syndrome (NAS) and their mothers. NAS is a group of signs exhibited by newborns exposed to addictive drugs taken by a mother during pregnancy. Infants with neonatal abstinence syndrome have prolonged hospital stays, experience serious medical complications, and are very costly to treat.
Medical Research: What are the main findings?
Dr. Lind: In this investigation, 242 infants with neonatal abstinence syndrome were identified in three Florida hospitals during a 2-year period (2010–2011). Nearly all of the infants with NAS were exposed to opioid painkillers during pregnancy (99.6%) and experienced serious medical complications, with more than 97% being admitted to an intensive care unit, where the average length of stay was 26 days. Despite a high prevalence of positive urine toxicology tests during the birth hospitalization, only a small proportion of mothers had documentation of referrals for drug counseling or rehabilitation.
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MedicalResearch.com Interview with:Marc Ellsworth, M.D
Neonatology fellow at the
Mayo Clinic Children’s Center
MedicalResearch: What is the background for this study? Dr. Ellsworth: Inhaled Nitric Oxide (iNO) is a drug that has FDA approval for use in neonates >34 weeks gestational age. It is used for severe respiratory failure secondary to pulmonary hypertension. However, it has been previously shown that neonatologists have been using this medication off-label and especially in the most premature neonates. Over the last 10 years there have been multiple large studies trying to determine a clinical use (ie long term benefit) for iNO in preterm neonates (patients where there is no FDA approval for iNO use currently). Despite evidence of short term benefit (improved clinical stability) use of this drug has not been shown to improve long-term outcomes (death and chronic lung disease) in premature neonates. As a result of these findings the National Institute of Child Health and Human Development (NICHD) released a consensus guideline in 2011 indicated that available evidence did not support the routine use of iNO in preterm neonates and discouraged this use of this expensive therapy in preterm neonates. Similarly, in 2014 the American Academy of Pediatrics issued a similar statement with similar recommendations.
In 2014 a group of NICUs (collectively called the Neonatal Research Network) associated with the NICHD published a report showing that the use of Inhaled Nitric Oxide in preterm infants (ie off-label) decreased following the report in 2011.
However, I did not feel that these NICUs were representative of the United States alone as the Neonatal Research Network consists of only a handful of NICUs (~15) and is directly associated with the NICHD. As a result I wanted to get a better idea of Inhaled Nitric Oxide use in a population based study to see if the trends were similar (ie use of iNO has been decreasing) on a much larger, more representative scale. (Editorial comment: My anecdotal experience was that rates of iNO use off-label have not decreased in preterm neonates since the 2011 report).
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MedicalResearch.com Interview with:Sylvie Babajko, PhD
Centre de Recherche des Cordeliers
Inserm UMR_S 1138
Laboratoire de Physiopathologie Orale Moléculaire
75006 Paris cedex 06
MedicalResearch:What is the background for this study? What are the main findings?Dr. Babajko: The environment has become increasingly contaminated by various pollutants. This has led to an increase in the incidence and gravity of known pathologies and/or the emergence of new pathologies. In 2001, a distinct enamel pathology called molar incisor hypomineralization (MIH) was described. It is diagnosed by white to brown creamy lesions affecting permanent first molars and frequently permanent incisors too. These teeth are sensitive and susceptible to caries. MIH prevalence turns around 15-18 % of 6 to 9 years-old children in studied populations all over the world. To date, MIH etiology remains unclear. However, given that MIH affects those teeth that are undergoing mineralization around the time of birth, MIH is indicative of some adverse event(s) occurring during early childhood that impact on enamel development. Interestingly, susceptibility to BPA in human is the highest during the same period of time.
Our experimental data (1, 2) showed that BPA may be a causal agent of MIH and that BPA irreversibly impacts amelogenesis via steroid hormone pathway. (more…)
MedicalResearch.com Interview with:
Su-Ying Wen, MD
Chief of Department of Dermatology,
Taipei City Hospital, Renai Branch, Taipei City, Taiwan
Department of Dermatology, Taipei City Hospital, Renai Branch, Taipei City, Taiwan
Medical Research: What is the background for this study? What are the main findings?
Dr. Su-Ying Wen: Though herpes zoster is seen as a disease of the elderly, it can affect individuals in any age group including children. There are limited population-based data regarding pediatric herpes zoster.
We reported a higher incidence rate of pediatric herpes zoster than in previous studies. The higher incidence observed in this population-based study might be because it was measured in a cohort of children who were all infected with varicella rather than as other reports including individuals free of varicella infection in the denominator. Children younger than 2 years at the diagnosis of varicella had a significantly higher risk and shorter duration of developing herpes zoster. (more…)
MedicalResearch.com Interview with:
Alberto Pappo, M.D.
Member, Oncology; Director, Solid Tumor Division
St. Jude Children’s Research Hospital
Medical Research: What is the background for this study? What are the main findings?Dr. Pappo: Researchers have identified three distinct subtypes of childhood and adolescent tumors of pigment-producing skin cells called melanocytes. The subtypes have different genetic alterations and often different outcomes for patients. The findings should aid efforts to improve diagnosis and treatment of melanoma, which is the most common skin cancer in children and adolescents.
The study provides the most comprehensive analysis yet of the genetic alteration underlying pediatric melanoma, including the first genetic evidence that sun damage causes melanoma in children and adolescents as well as adults. Researchers used whole genome sequencing and other techniques to study the normal and cancer genomes of 23 young patients with a variety of melanocytic tumors, including conventional melanoma. Patients ranged in age from 9 months to 19 years old.
The melanoma subtypes in this study included conventional melanoma, which scientists showed was the same disease in children, adolescents and adults. More than 90 percent of pediatric conventional melanoma had DNA changes linked to sun damage.
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MedicalResearch.com Interview with:
Anita Kozyrskyj Ph.D
Professor, Department of Pediatrics
University of Alberta
Medical Research: What is the background for this study? What are the main findings?
Prof. Kozyrskyj: Our study determined what "good" gut bacteria were present in 166 full-term infants enrolled in the Canadian Healthy Infant Longitudinal Development (CHILD) Study. Funded by CIHR and AllerGen NCE, this landmark study involves more than 3,500 families and their newborn infants across Canada. Gut bacteria were identified by DNA sequences extracted from infant poop.
Infants with a fewer number of different bacteria in their gut at 3 months of age were more likely to become sensitized to foods such as milk, egg or peanut, by the time they were 1 years old. Infants who developed food sensitization also had altered levels of two specific types of bacteria, Enterobacteriaceae and Bacteroidaceae, compared to infants who didn’t. (more…)
MedicalResearch.com Interview with:
Dr. Kevin Vagi, Ph.D
Division of Violence Prevention,
CDC’s Injury Center.
MedicalResearch: What is the background for this study? What are the main findings?Dr. Vagi: Although there has been research on teen dating violence (TDV) for several decades, the subject has only received attention as a public health concern in recent years. Over time, prevalence estimates of physical teen dating violence victimization from CDC’s national Youth Risk Behavior Survey (YRBS) (first measured in 1999) have remained around 9% with similar rates among female and male students. Until recently, there have been no ongoing national studies of sexual TDV to our knowledge.
This article describes new physical and sexual teen dating violence victimization questions first administered in the 2013 YRBS, shares the prevalence and frequency of TDV and national estimates using these new questions, and assesses associations of teen dating violence experience with health-risk behaviors. By including questions on both physical and sexual TDV, we are able to look at those youth who experienced physical TDV only, sexual TDV only, both physical and sexual TDV, any TDV, and none. These distinctions were important when investigating health outcomes associated with different types or combinations of TDV, as some health-risk behaviors have been shown to be associated with certain types of teen dating violence but not others.
In 2013, among high school students who dated, 1 in 5 females and 1 in 10 males experienced physical and/or sexual TDV in the 12 months before the survey. The majority of students who experienced physical and sexual teen dating violence experience it more than once. Students who experienced both physical and sexual TDV are more likely to have other health-risks, such as suicidal ideation and behavior, fighting, carrying a weapon, being electronically bullied, alcohol and drug use, and risky sexual behaviors. This report also offers the first national estimate of sexual TDV. Findings suggest that comprehensive prevention efforts should focus on helping students develop healthy relationship skills to prevent teen dating violence and other risk behaviors. (more…)
MedicalResearch.com Interview with:
Antti Saari, M.D.
Department of Pediatrics
University of Eastern Finland and Kuopio University Hospital
Kuopio Finland
MedicalResearch: What is the background for...
MedicalResearch.com Interview with:
Ina S. Santos (on behalf of the co-authors)
Iná S. Santos, MD, PhD
Professora Titular Depto Medicina Social
Programa Pós-graduação Epidemiologia
Universidade Federal de Pelotas, Brasil
MedicalResearch: What is the background for this study? What are the main findings?Response: Early regulatory problems (excessive crying, sleeping and feeding problems in infancy) have been considered early markers for similar processes of inadequate or under-controlled behavior in childhood and psychosocial problems in childhood are associated with psychological disorders later in life. The prevalence of excessive crying during the first 3 months of life in representative community-based samples from high-income countries has been reported to range between 14% and 29%.
There is no consensus regarding the definition of excessive crying. A frequently used definition is the excessive paroxysmal crying, that is most likely to occur about the same time every day (usually in the late afternoon or evenings) without any identifiable cause in an otherwise healthy baby aged 2 weeks to 4 months and lasting more than three hours per day, occurring in more than three days in any week for three weeks (rule of three) that is typically known as colic. Others give less emphasis to the amount of crying and give relevance to maternal or parental stress due to the child unresponsiveness to soothing or to the maternal perception of the intensity of crying.
Negative consequences of excessive crying on maternal and child health have been described: it is associated with early weaning from breast milk, frequent changes of formulae, and maternal mental symptoms, besides being the most common proximal risk factor for shaken baby syndrome.
In a study conducted in a middle-sized city located in Southern Brazil, 4231 children enrolled in the 2004 Pelotas Birth Cohort were followed-up from birth to four years of age. At the 3-month post-partum follow-up mothers were asked whether their infants cried more, less or as the same as others of the same age. Infants whose mothers perceived them as crying more than others of the same age were classified as “crying babies”. When the cohort reached four years old, all children were screened to assess their risk of presenting psychological problems. After taking into account a series of maternal and child characteristics (like, maternal age, maternal level of education, type of delivery, gestational age at birth, and child sex, among others) “crying babies” were at increased risk of presenting behavior problems in comparison to “non-crying babies”.
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MedicalResearch.com Interview with:
Dave Kennaway, PhD Professor
Lloyd Cox Senior Research Fellow,
Head Circadian Physiology Laboratory
School of Paediatrics and Reproductive Health
Robinson Research Institute,
Faculty of Health Sciences, Medical School,
University of Adelaide Australia
MedicalResearch: What is the background for this review? What are the main findings?Dr. Kennaway: There is evidence that melatonin is being prescribed to for sleep disorders in children and adolescents who are developing normally despite the fact that there have been no properly designed studies on the effects of prolonged administration to children. In countries where melatonin has been registered, it is for use as a monotherapy for the short term treatment of primary insomnia, characterised by poor quality of sleep in patients who are aged 55 years and over. Use in Paediatrics is always “off-label”. After more than 50 years of melatonin research in animals there is overwhelming evidence that melatonin administration affects many organ systems. These include important effects on the reproductive organs of rodents, cats, ruminants and primates and melatonin is in fact registered as a veterinary drug for this purpose. The effects of melatonin, however, go beyond the potential reproductive consequences, including effects on cardiovascular, immune and metabolic systems. It is clear that many paediatricians, practitioners and parents are unaware of this.
MedicalResearch: What should clinicians and patients take away from your report?Dr. Kennaway: Clinicians and patients need to recognise that melatonin is a hormone and not a drug developed for a specific purpose or illness. There have been no appropriate trials in children addressing the effects of prolonged administration of melatonin in children. Given the extensive literature on the role of the hormone in normal physiology it is unlikely that such trials would ever be approved. Should endocrine or other abnormalities appear in the future in children previously treated with melatonin it will not be tenable to argue that we were surprised.
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